JP7530552B2 - Dementia patient outing support system - Google Patents

Description

The present invention relates to a system that supports dementia patients going out on their own, and more specifically, to a dementia patient outing support system that combines a pedestrian navigation system that guides the actions of dementia patients based on an outing schedule that includes a preset outing destination, route, means of transportation, etc., with a support system that detects the onset and signs of dementia symptoms from the physical condition and situation of dementia patients while out and works to ensure their recovery and safety.

In Japan, which has become an ultra-aging society, the number of dementia patients is expected to reach around 7 million by 2025, when the baby boomer generation will be 75 years old or older, accounting for one in five people aged 65 or older. There are various types of dementia, including Alzheimer's disease, vascular dementia, Lewy body dementia, and frontotemporal dementia, and the core symptoms include memory loss, disorientation, and impaired judgment.

As dementia progresses, memory impairment and impaired judgment make it difficult for patients to plan and organize things, which can interfere with social life and interpersonal relationships and cause a loss of independence in daily life. In particular, patients are often restricted or prohibited from going out alone for reasons such as ensuring their own safety, worrying or burdening their family, and causing trouble for others. However, since many dementia patients have will, experience, and self-esteem just like healthy people, restricting their behavior, especially restricting or prohibiting them from going out alone, can easily lead to a denial of the patient's humanity and a decline in their quality of life. Furthermore, unilateral restrictions on behavior undermine the patient's independence and deprive them of stimulation in life, which can actually be a factor in the progression of dementia.

In general, the degree of independence of dementia patients in daily life varies greatly from person to person. As shown in Figure 1, the Ministry of Health, Labor, and Welfare's Bureau of Health and Welfare for the Elderly's "Criteria for Dementia Elderly Independence in Daily Life" classifies dementia patients from "Rank 1" (has some form of dementia, but is almost independent in daily life at home and in society) to "Rank 4" (frequently shows symptoms and behaviors that interfere with daily life and difficulty in communication, and constantly requires care). For dementia patients judged to be at "Rank 3" or higher, going out alone is too dangerous, but for those at "Rank 2" or lower, proactively going out is considered to be effective in preventing the progression of dementia. In addition, such relatively mild dementia patients generally have high self-esteem and ambition, and often wish to go out alone without a caregiver accompanying them.

If a system could be developed that could provide appropriate and safe guidance to patients with relatively mild dementia (specifically, the aforementioned "Level 1 to 2") when going out alone, and that could automatically take the necessary recovery measures if it detected the onset or signs of dementia, and that would notify family members or other caregivers, or the police, etc. if the patient still did not recover or in the event of an emergency, it would not only reduce the burden on caregivers of accompanying the patient, but it would also be expected to help restore confidence and improve the quality of life of dementia patients who were previously thought to be "unable to do anything on their own."

Here, so-called pedestrian navigation systems for guiding and guiding outing behavior have already been realized as smartphone applications with a fairly high degree of accuracy, and by linking with map service systems and public transportation timetable data, etc., it is possible to provide guidance on optimal routes and transfer methods. Furthermore, a system that can provide guidance on optimal routes and transfer methods taking into account the physical conditions of elderly people and people with disabilities who cannot use stairs, elevators, escalators, etc. in the same way as able-bodied people, such as the railway network optimal route guidance system described in Patent Document 1, has been proposed. In addition, a system that monitors the behavior of elderly people using a portable behavior monitoring device and monitors abnormalities such as deviation from the permitted movement range and falls, such as the behavior monitoring system described in Patent Document 2, has also been proposed. On the other hand, as for systems for monitoring and managing personal safety and health conditions, a system has been proposed that records the situation when a dementia patient or the like encounters an accident and notifies a monitor, such as the monitoring recorder and monitoring system described in Patent Document 3. In addition, a system that can detect biological information indicating the user's health condition and take appropriate measures according to the changed health condition, such as the health management system described in Patent Document 4, has also been proposed.
JP 2003-54407 A JP 2007-279837 A JP 2019-83423 A JP 2015-72664 A

These prior art technologies do not necessarily take into sufficient consideration the following characteristics seen in patients with relatively mild dementia: (1) Under normal circumstances, they do not consider that their own experiences or judgments may be wrong; (2) therefore, they dislike excessive intervention from the system when they are acting alone, and would prefer to make their own judgments and decisions; (3) however, it is difficult for them to keep in mind the entire complex outing schedule and sequentially correct their actions; and (4) they easily fall into panic mode when symptoms suddenly appear or they are unable to grasp their own situation.

The conventional pedestrian navigation system, including the prior art, is intended to be used by a healthy person who operates a smartphone or the like by himself/herself. In addition, if there is a delay or deviation from the schedule on the route to the destination for some reason, the user is expected to reset a new schedule by himself/herself. On the other hand, for many dementia patients, there is a risk that they may forget the basic steps of operating an electronic device such as a smartphone, so it is desirable for guidance guidance to be provided by voice according to the situation. In addition, dementia patients often cannot immediately recognize delays or deviations, and when they do become aware of a delay or deviation, they are confused and in some cases often fall into a state of panic. Therefore, guidance guidance in a navigation system that is intended for use by dementia patients should prevent delays or deviations from the schedule while allowing the patient to appropriately confirm the actions to be taken in the near future, and if the delay or deviation becomes irreversible or symptoms develop, it is desirable to automatically reset the schedule (Plan B), and to simultaneously set a schedule for returning home from that place and time to ensure the patient's safety, present it to the patient, and allow the patient to select it by himself/herself.

Furthermore, the prior art systems for monitoring and managing personal safety and health monitor the user's behavior and health, and if they detect an abnormality, they report it to a designated institution, etc., or send a message or an alarm sound to the user by email or telephone to urge them to take appropriate measures and respond. On the other hand, dementia patients tend to fall into a state of tension due to amnesia, disorientation, misunderstandings, etc., which can trigger panic attacks, so an outing support system for dementia patients is required to detect sudden warning signs, calm the patient with appropriate support sound, and, in cooperation with navigation, guide the patient back to their schedule as much as possible, or return home safely.

Going out (destinations, purposeful activities, etc.) is a first experience for a dementia patient, and it is stimulating and gives the patient confidence, so it can be expected to be effective in slowing the progression of dementia. However, it also entails high risks for the patient and causes great anxiety for caregivers. For this reason, it is desirable for the patient and caregiver to simulate an actual outing schedule before the "real" outing alone, and to be able to revise the outing schedule and guidance contents as appropriate, taking into account anticipated risks and the patient's own wishes.

In view of the above, the present invention aims to provide an outing support system that takes into account the characteristics of symptoms of relatively mild dementia patients, safely and appropriately supports their independent outings, reduces the burden and anxiety of caregivers, and encourages dementia patients to actively go out.

In order to solve the above problems, the dementia patient going out support system according to claim 1 of the present application is a dementia patient going out support system including a patient terminal worn on the patient's body, a caregiver terminal having a management application, and a server capable of communicating with the patient terminal and the caregiver terminal via the Internet and a mobile communication network,
The patient terminal includes at least a position detection means, a condition detection means capable of detecting condition data of a patient, a voice input/output means, a video input means, and a voice recognition means;
The server includes at least a storage unit, a navigation unit, and a support unit;
The storage unit is
an outing schedule generated by the navigation unit based on the setting input of the patient's outing trip, the outing schedule including at least a round trip route to a destination, times and transfers of public transportation to be used, a stay time at the destination, and a planned return time;
Reference state data is normal state data including a standard walking speed of an individual patient;
A parameter table defining criteria for determining symptoms of dementia;
A countermeasure table that defines the relationship between countermeasures to be taken according to symptoms, a guide voice for navigation, a support voice for support corresponding to each countermeasure in the countermeasure table, and a countermeasure database that registers voice data such as a contact voice for a predetermined target other than the patient, can be set, rewritten, added, deleted, and stored by the management application;
Throughout the patient's journey,
The navigation unit executes navigation by voice guidance corresponding to an outing schedule,
when a delay or deviation is detected due to a mismatch between the patient's current location detected by the location detection means and the planned location in the going - out schedule, a route to the destination at the time of detection is recalculated, and when it is determined based on the result of the recalculation that returning to the going -out schedule is impossible, a next-best modified schedule from the current location to the destination and home and a home schedule from the current location to the home after abandoning the going-out behavior are recalculated based on the time and location at the time of determination, and presented to the patient, and navigation is performed according to the patient's selection.
The support unit compares the patient's condition data detected by the condition detection means with the reference condition data, and if a symptom of dementia defined in the parameter table is detected as a result of the comparison, the support unit executes a countermeasure by referring to the countermeasure table and outputting a predetermined support voice corresponding to the symptom.

The patient terminal may take any form, but considering the provision of an audio input/output means capable of detecting the patient's voice and an image input means capable of capturing an image from the patient's viewpoint, it is desirable for the patient terminal to be an information and communications terminal that includes a so-called eyewear-type device that can be attached to a glasses-type frame or to glasses worn by the patient. The caregiver terminal can be configured as an information and communications terminal such as a smartphone or tablet terminal with the management application pre-installed. The patient terminal and the caregiver terminal can communicate with the server via the Internet, and the patient terminal and the caregiver terminal can also make voice calls to each other via a mobile communications network.

The position detection means is, for example, a GPS antenna. The condition detection means is composed of a group of vital sensors capable of detecting the health condition of the patient, and a motion sensor capable of detecting condition data related to the physical condition of the patient's body from the position and acceleration of the movement of each part of the patient's body. As the group of vital sensors, sensors that can be attached to the patient's skin to detect body temperature, blood pressure, pulse rate, respiratory rate, and sweating (specifically, the pH value of the skin), and pupil sensors that can be mounted on eyeglass frames to detect the opening and closing of eyelids, blinking, and dilation and contraction of the pupils, have also been put to practical use. Also, excretion sensors that can be attached to underwear or diapers to detect the state of the bladder with ultrasound and display the timing of excretion numerically have been put to practical use. On the other hand, as the motion sensors, those that can be attached to the head (eyewear type device), waist, wrist, and ankle have been put to practical use, and they can detect three-dimensional position information and acceleration of each body part by combining an acceleration sensor, a gyro sensor, and a geomagnetic sensor.

The voice input/output means is, for example, a microphone, earphones, and speaker that can be attached to the eyewear-type device. The microphone is capable of detecting the patient's voice and external sounds, and the earphones used to guide the patient through audio guidance can be bone conduction earphones as well as earphones that are normally worn in the ear. The speaker is used to convey messages to people nearby by voice in emergencies or when the patient terminal is removed. The video input means is, for example, a small television camera that can be attached to the eyewear-type device. The voice recognition means is, for example, software that can recognize basic indications of intent such as confirmation and response from the patient's voice, and can be implemented in either the patient terminal or the server.

In the configuration of the server, the outing schedule stored in the memory unit is navigation data generated by the navigation unit based on requirements such as the destination, stopovers, target arrival time, and duration of stay for the outing action that are set and input by a caregiver such as a family member through the management application on the caregiver terminal.

The reference condition data for each patient is a standard walking speed detected by GPS and vital data such as body temperature, blood pressure, pulse rate, and respiratory rate measured by the vital sensor group when a healthy and calm patient wears a patient terminal and walks or does light exercise. The parameter table defines the correspondence between characteristic events (patient condition) for each type of dementia and abnormal parameters (increase, decrease, fluctuation, stop/slow speed) such as the vital data, motion (positional relationship of each body part and acceleration), the patient's movement state detected by GPS, and outside temperature and humidity, and can be shown, for example, as in Figure 2 (premonition stage) and Figure 3 (onset stage). The normal/abnormality of a parameter is determined based on whether or not a preset threshold value for each parameter has been exceeded, or whether or not a preset specific event has been detected.

The countermeasure database is made up of voice data such as countermeasures to be taken for characteristic events for each dementia type in the parameter table, specifically, navigation guide voices to be played to the patient through earphones, support voices for support in the event of an abnormality, and voices for contacting a specified third party, and is configured to output by replacing proper nouns and other parts as necessary in the navigation unit and support unit. For example, based on the countermeasure table as exemplified in FIG. 4, when a symptom precursor is detected or when the symptom occurs for each event, a support voice as exemplified in FIG. 5 is output from the earphones. Note that the support voices shown are examples, and can be arbitrarily set, rewritten, or added by the management application of the caregiver terminal.

The navigation unit provides guidance and instruction to the destination, such as the route and direction to travel, right and left turns, boarding/alighting from and transferring to public transport, by outputting a guide voice, based on the current position detected by GPS, map data, and public transport timetables. The navigation unit can be equipped with a navigation system specific to this system, but by implementing an application system on the server that can link with existing web services such as pedestrian navigation services, map services, and public transport timetable information, it is possible to set and recalculate (reroute) outing schedules, and furthermore to configure the guide voice in the countermeasures database so that it can be set, rewritten, and added as desired.

When the dementia patient outing support system is in operation, the support unit constantly receives the condition data of the patient's health condition and physical state detected by the condition detection means of the patient terminal and compares it with the reference condition data. If a parameter of the condition data exceeds a preset threshold value of the reference condition data, or if a preset specific event is detected, it is determined to be abnormal, and determines the onset or onset of a dementia symptom based on the definition of the parameter table. Furthermore, the support unit determines countermeasures for the determined symptoms by referring to the parameter table, and outputs a specified support voice in the countermeasure database from the patient's earphones, or makes it possible to make an emergency call to the caregiver terminal or an emergency medical institution or police station.

Next, the invention according to claim 2 is the dementia patient outing support system described in claim 1, characterized in that when the support unit detects a symptom of dementia, the navigation unit reduces the standard walking speed by a predetermined rate, recalculates the modified schedule and the home schedule, presents them to the patient, and executes navigation according to the patient's selection.

Even if the support unit detects the onset or signs of dementia symptoms, if the severity is minor or the status data returns to within the threshold of the reference status data by implementing measures via voice support, the navigation unit will continue navigation based on the set outing schedule as long as there is no delay or deviation. However, if a delay or deviation occurs after detecting the onset or signs of dementia symptoms and returning to the outing schedule becomes impossible, some causal relationship with the symptoms is presumed and it is highly likely that the patient's walking speed has also decreased. If this is the case, it is desirable for the modified schedule and home schedule presented by the navigation unit to be recalculated taking into account the decrease in walking speed.

Therefore, when the navigation unit recalculates the revised schedule and the home schedule after the support unit detects the onset or signs of dementia symptoms, the redundancy of the presented schedule can be increased by recalculating the patient's walking speed to, for example, 20% slower than the standard walking speed. In other words, once the support unit detects dementia symptoms while going out, the decrease in the patient's walking speed is reflected in the subsequent schedule recalculation by the navigation unit.

With this configuration, even if the arrival time at the destination or home is slightly delayed, the possibility of delays in the new schedule can be reduced, and the burden on the patient caused by repeating the process of responding to delays and deviations can be reduced. Note that the rate at which the walking speed is reduced may be uniform regardless of symptoms, but it is desirable to set it individually depending on the type of condition data in which the abnormality was detected and the level of the abnormality.

The invention according to claim 3 is a dementia patient outing support system according to claim 1 or 2, characterized in that the server integrates the patient's condition data detected by the condition detection means and the audio/video data input from the audio input/output means and the video input means throughout the patient's outing, transmits the integrated data to the caregiver terminal, and enables monitoring by the management application.

The management application enables a monitor display that can be viewed on the caregiver terminal. The monitor display allows the caregiver to view in real time an external image from the patient's viewpoint captured by the video input means of the patient terminal, and the patient's voice and external sounds collected by the audio input/output means, and also displays vital data such as the patient's body temperature, blood pressure, pulse rate, and respiratory rate as numerical values and graphs, and can display a warning about vital data that shows abnormal values.

The invention according to claim 4 is the dementia patient outing support system described in claim 3, wherein the server generates log data that integrates in chronological order the records of navigation performed by the navigation unit, the records of the patient's condition data, the records of measures performed by the support unit, and the audio and video data recorded by the audio input/output means and the video input means throughout the patient's outing, stores the log data in the storage unit, and enables output on the caregiver terminal by the management application, and also enables the management application to reset the navigation guide voice corresponding to the schedule or the support voice corresponding to the measures, as necessary.

According to the dementia patient outing support system of claim 1, if the patient's behavior is delayed or deviates from the set outing schedule and cannot be restored, the system recalculates the next best modified schedule and the home schedule and presents them to the patient, and continues to guide and guide the patient according to the patient's own selection, thereby maintaining the patient's dignity and ensuring safety at the same time. In addition, by detecting symptoms specific to dementia and outputting support voices corresponding to the symptoms to encourage self-recovery and returning to the schedule as much as possible, the system is expected to improve the patient's success rate in going out alone, which will contribute to inhibiting the progression of dementia and improving the quality of life.

According to the dementia patient outing support system of claim 2, once the support unit detects symptoms of dementia while outing, the navigation unit will reflect the patient's decreased walking speed in the subsequent schedule recalculation, increasing the redundancy of the revised schedule and making further delays less likely to occur, thereby reducing the burden on the patient.

According to the dementia patient outing support system of claim 3, even when the patient is out alone, caregivers etc. can remotely monitor the patient's behavior and condition data in real time using a management application, thereby reducing the burden and anxiety of caregivers etc. and enabling a rapid response to unexpected emergency situations.

According to the dementia patient outing support system of claim 4, the navigation of the patient's outing itinerary, the measures taken by the support department, the patient's condition data, and the situation by video and audio are recorded as integrated log data, and can be output by the management application.
Caregivers can verify problems and risks in the patient's outings and the validity of the set schedule, improving the accuracy of future schedule settings. In addition, by allowing caregivers to reconfigure the guide and support voices from the management application as needed, navigation and measures can be optimized and improved in accuracy based on the patient's individual wishes and responses to voice.

Below, an embodiment of the present invention will be described with reference to the drawings. Figure 6 shows an example of the configuration of a dementia patient outing support system (hereinafter referred to as "this system") according to the present invention. This system is composed of a patient terminal 1, a caregiver terminal 2, and a server 3, and each component is capable of data communication with each other via the Internet N, and the patient terminal 1 and the caregiver terminal 2 are also capable of direct voice calls via a public mobile phone network. The server 3 also enables data communication with various web services via the Internet N, as well as data communication with an emergency/police information communication terminal E and an information communication terminal M of a medical institution.

The patient terminal 1 comprises at least a position detection means 10, a state detection means 11, a video input means 12, a voice recognition means 13, a voice input/output means 14, and a control communication unit (patient terminal) 15. In this embodiment, the position detection means 10 is a GPS antenna, and the state detection means 11 is a group of vital sensors capable of detecting vital data such as body temperature, blood pressure, pulse rate, respiratory rate, sweating, pupils, and excretion, a motion sensor capable of detecting the position and acceleration (motion data) of each part of the patient's head, waist, hands, and feet, and a temperature and humidity sensor for detecting temperature and humidity data. In this embodiment, the video input means 12 is a web camera, and the voice input/output means 14 comprises a microphone for detecting the patient's voice and external sounds, a bone conduction speaker for playing guide voices and support voices to the patient, and an external speaker for emitting support voices to the outside in certain cases. The voice recognition means 13 is software that recognizes the voice of the patient or an external third party detected by the microphone and makes it possible to compare it with specific voice data in the countermeasures database C described below.

All components except for the condition detection means 11 are mounted on a main body in the shape of an eyeglasses-type frame, and each vital sensor of the condition detection means 11 is attached to an appropriate part of the patient's body by means of pasting or the like, and is connected to the main body via wired or short-range wireless communication such as Bluetooth (registered trademark) to enable data communication with the main body's control communication unit (patient terminal) 15. Note that the control communication unit (patient terminal) 15 is equipped with the functionality of a mobile phone terminal capable of voice calls with the caregiver terminal 2. Also, the voice recognition means 13 does not necessarily need to be mounted on the patient terminal 1, and may be provided on the server 3.

The caregiver terminal 2 is a general smartphone or tablet with a control management unit (caregiver terminal) 21 that can connect to the Internet and public mobile phone networks, and has a management application 20 installed. The management application 20 accesses the server 3 to create and change an outing schedule. It also enables a monitor display that can be viewed on the caregiver terminal 2. Specifically, it enables the caregiver to view in real time an external image from the patient's viewpoint captured by the video input means 12 of the patient terminal 1, and the patient's voice and external sound collected by the audio input/output means 14, and also displays the patient's vital data such as body temperature, blood pressure, pulse rate, and respiratory rate as numerical values and graphs, and can display a warning about vital data that shows abnormal values. In addition, the caregiver can access the server 3 using the management application 20 to modify, add, and delete the guide voice and support voice in the countermeasures database C.

The server 3 is composed of at least a memory unit 30, a navigation unit 31, a support unit 32, and a control communication unit (server) 33. The memory unit 30 is a storage medium capable of storing an outing schedule 34, reference state data R, a parameter table P, a countermeasure database C, and log data L. The navigation unit 31 and the support unit 32 are each information processing application software, and are constructed on independent storage media within the server 3 or on the memory unit 30 to process information and communicate data via the control communication unit (server) 33.

The log data L is a chronologically integrated data stored in the memory unit 30 as a record of the navigation performed by the navigation unit 31 while the system is running, a record of the patient's condition data, a record of the measures performed by the support unit 32, and each of the audio and video data recorded by the audio input/output means 14 and the video input means 12, and can be output on the caregiver terminal 2 by the management application 20.

(Setting of reference state data)
In the dementia patient outing support system according to the present embodiment, the patient's reference state data R is stored in advance in the storage unit 30 of the server 3 before the patient actually goes out alone. Specifically, the system is started with the patient wearing the patient terminal 1, and the patient in a calm state is asked to walk for a certain period of time in an outdoor space where the patient does not feel any particular tension (for example, a familiar area around the patient's home or a nearby park, etc.), during which the patient's standard walking speed measured by the GPS antenna as the position detection means 10 and the vital data detected by the vital sensor group are recorded in the storage unit 30. This recording operation is repeated as many times as possible by changing the load such as the time period and walking distance, and the standard walking speed and the average value, minimum value, and maximum value of each vital data are set in the storage unit 30 as the reference state data R. The reference state data R is basically set to the minimum and maximum values of each vital data as patient-specific threshold values for determining normality/abnormality, but it is desirable to appropriately modify the threshold values based on the patient's medical examination records, etc., under the guidance of a specialist who is aware of the patient's health condition and dementia symptoms, such as a family doctor.

(Countermeasures database)
The countermeasure database C according to the present embodiment is a set of pre-recorded voice data and text data of guide voices used for navigation, support voices used for support in the event of an abnormality, voices for contacting a third party, and specific voices. The specific voices are the patient's specific responses to the specific guide voices and support voices of the system (such as "Yes,""No,""Okay,""Idon'tunderstand,""It'sokay,""It's not okay," etc.), specific questions or instructions from the patient to the system (such as "Where do I go next?", "Which way do I go next?", "Where am I?", etc.), and specific phrases that may trigger panic in the patient (such as "You idiot,""Hey!", etc.). The voice of the patient or a third party around him/her detected by the microphone is recognized by the voice recognition means 13 by comparing it with the text data of the specific voices recorded in the countermeasure database C.

Furthermore, among these voice data, at least the guide voice and support voice are configured so that words that change depending on the situation, such as proper nouns such as place names, names of means of transport, and people's names, can be replaced with any word, and the navigation unit 31 is configured to be able to output the appropriate replacements based on the outing schedule 34, current location information, etc. Furthermore, the caregiver, etc. can access the countermeasures database C using the management application 20 and arbitrarily set, rewrite, or add guide voice, support voice, contact voice, and specific voice by text input or voice input.

(Outing schedule creation process)
In this system, an outing schedule is created before the patient goes out. If possible, the patient may create the outing schedule by himself/herself, but it is basically assumed that a caregiver or the like will confirm the patient's intention and then execute the outing schedule creation process 100 in the management application of the caregiver terminal 2.

Figure 7 is an example of a flowchart of the outing schedule setting process 100. First, the destination of the outing is set (101). At this time, if a past outing schedule with the same destination has already been registered, it can be selected. Next, if there is a specific appointment time or time period to arrive at the destination, the arrival time is set (102). If the required time for staying at the destination is estimated, the standard and maximum required time are set (103). Furthermore, if there is a person to be contacted if necessary, the contact information (phone number or email address) of that person is set (104). Next, if multiple destinations are planned for one outing, the above setting procedure can be used to add destinations.

After the above settings are made, when the navigation unit 31 is commanded to generate a proposed outing schedule, the navigation unit 31 accesses an external route search service and map service via the Internet, calculates a proposed outing schedule that satisfies the set conditions, and displays it on the screen of the management application 20. At this time, the proposed outing schedule includes not only the round-trip travel route, the times and transfers of the public transportation to be used, the time spent at the destination, and the planned time of returning home, but also the destination, points to turn right or left, and all points to get on and off the public transportation such as stations and bus stops as waypoints (WPs), and when multiple proposed outing schedules that satisfy the set conditions are generated, the number of transfers of the public transportation to be used and the number of waypoints are also displayed. For dementia patients, it is generally believed that the more transfers and stops there are, the more difficult the outing schedule becomes, and the later the planned return home time is, the higher the risk becomes. Therefore, the caregiver etc. selects an outing schedule by comparing the difficulty and risk of the multiple outing schedule proposals S displayed, and if it is determined that none of the outing schedule proposals are appropriate, the caregiver etc. returns to the beginning of the flowchart and resets the conditions, and the finally determined outing schedule S1 is stored in the memory unit 30 of the server 3.

The difficulty level mentioned above also varies depending on the congestion level of the public transportation means used depending on the time of day, the danger level of the route, the weather, etc. Therefore, if the route search service provides data on the expected congestion level of the transportation means, or if the map service provides hazard map data of areas with high danger to pedestrians, these can be displayed together with the proposed outing schedule as indicators of difficulty and risk, allowing caregivers and others to make more appropriate choices.

(Configuration of the outing support process)
The process of actually supporting a patient to go out using the dementia patient going out support system according to this embodiment is composed of five processes: a guide process 200, a delay/deviation response process 300, a follow-up process 400, a support process 500, and a panic response process 600. When a patient starts going out, this system immediately starts the guide process 200 and the follow-up process 400.

(Guide process, delay/deviation response process)
8 is an example of a flowchart of the guide process 200 and the delay deviation response process 300. After the patient wears the patient terminal 1 when going out, the caregiver or the like starts the management application 20 of the caregiver terminal 2, selects the going out schedule S1 stored in the storage unit 30 of the server 3, and starts the guide process in the navigation unit 31 to start navigation (201).

After the patient leaves home alone, the navigation unit 31 constantly compares the patient's current location detected by the position detection means 10 of the patient terminal 1 with the planned location in the outing schedule S1 (202), and performs navigation by sequentially reading out guidance voices corresponding to the patient's location from the countermeasures database C and outputting them from the earphones of the patient terminal 1.

Figure 9 shows an outline of an outing schedule S1 and a guide voice, assuming a round trip by bus from "Home H" to the destination "Day Service Center D" and a specified time spent at the destination, as a specific example of navigation. In the navigation shown, not only the bus stops where the patient gets on and off, but also all points where the patient turns right or left on the route are set as waypoints WP, and the navigation unit 31 reads a specified guide voice from the countermeasures database C based on the relationship between the patient's current position and each waypoint WP, and plays it for the patient after replacing necessary proper nouns, etc. In the navigation shown, when the patient arrives at the destination "Day Service Center D", the patient removes the patient's terminal 1 and leaves it with a previously set facility staff member, and at the scheduled time to prepare to go home, an alarm message is issued from the external speaker to encourage the patient and the facility staff member to put it back on.

Navigation is performed as in the above example unless the patient's going-out behavior is significantly delayed or deviated from the going-out schedule S1. On the other hand, if the patient's current location does not match the planned location at the planned time of the going-out schedule S1 in the comparison 201, causing a delay or deviation, the navigation unit 31 recalculates the route to the destination D at that time (203), and if it is determined that the patient can return to the going-out schedule S1 as a result of the recalculation, it prompts the patient to increase his/her walking pace with a guide voice (recovery guide) (204), and resumes normal navigation once it has confirmed that the patient has returned to the going-out schedule S1. On the other hand, if the recalculation (203) determines that the delay or deviation is too large to return to the going-out schedule S1, or if the patient cannot confirm the return even after the recovery guide has been performed, the navigation unit 31 executes the delay/deviation response process 300.

The delay/deviation response process 300 calculates an outing schedule S2 (Plan B) for destination D and returning home based on the time and location at the time of execution, and a home schedule SH for canceling the outing and returning home (301), and presents an overview of both options (including the new scheduled time of arrival at destination D and returning home) to the patient by voice guidance and asks the patient to select (302). The reason why the patient is asked to select is to respect the patient's own dignity and independence. On the other hand, if the support unit 32 detects a symptom of dementia during the execution of the support process 500 described below and transitions to the panic response process 600 also described below, the navigation unit 31 reduces the standard walking speed by a specified rate, recalculates the changed schedule S2 (Plan B) and the home schedule SH, presents them to the patient, and executes navigation according to the patient's selection.

In accordance with the patient's selection, the navigation unit 31 resumes the guide process based on either the going-out schedule S2 (Plan B) or the returning-home schedule SH (303, 304), and executes the follow-up process 400 to contact the other party at destination D, the caregiver, etc., as necessary due to the schedule change. The follow-up process 400 will be described later.

When the navigation unit 31 presents the patient with the choice between an outing schedule S2 and a home schedule SH by executing the delay/deviation response process 300, it is expected that a dementia patient will become tense when they learn that there has been a delay or deviation, and may not respond to the presented options. If there is no response from the patient, the navigation unit 31 outputs a stay guide (305), which is a voice requesting the patient to stay in their current location for the time being and follow instructions from the system, and executes the panic response process 600. The panic response process 600 will also be described later.

(Support Process)
10 is an example of a flow chart of the support process 500 and the panic response process 600. After the patient leaves his/her home alone, the system immediately starts executing the support process 500. The patient terminal 1 continuously transmits status data, such as vital data, motion data, temperature and humidity data of the patient detected by the status detection means 11, external video data detected by the video input means 12, and patient or external voice data detected by the voice input/output means 14, to the server 3 (501), and the support unit 32 detects these status data, compares them with the parameter table P, and continues to monitor the presence or absence of abnormal values (502). If any of the parameters exceeds a preset threshold (tolerance range), the support unit 32 determines that an abnormality has occurred in the patient, and executes the panic response process 600.

(Panic response process)
In the panic response process 600, the support unit 32 estimates a precursor or onset of a dementia symptom from an abnormal value by referring to a parameter table P such as that shown in Figures 2 and 3, and determines a measure corresponding to the estimated symptom by referring to a countermeasure table such as that shown in Figure 4 (601). Then, the support voice such as that shown in Figure 5 is selected from a countermeasure database C, output, and played to the patient (602).

After implementing the countermeasures, the support unit 32 checks the patient's vital data from the patient terminal 1 (604) and checks the patient's condition through a support voice (605). If the support voice confirms that the patient has recovered from the symptoms, normal parameter monitoring is resumed. On the other hand, if the patient responds but the symptoms have not recovered, the support unit 32 contacts the caregiver terminal 2 by sending predetermined voice data including the patient's condition and current location from the countermeasures database C, and connects the voice call line to the patient terminal 1, enabling the caregiver to support the patient through a direct voice call (606). Furthermore, if the symptoms have not recovered and no response is obtained from the patient, in addition to contacting the caregiver terminal 2, the support unit 32 reports the emergency by sending a predetermined voice message including the patient's symptoms and current location from the countermeasures database C to the emergency/police terminal E and the medical institution terminal M (607).

Here, if the patient's safety is the only priority, it is desirable to immediately contact a caregiver when the onset of symptoms is confirmed, or to immediately notify an emergency department, police, medical institution, etc. when it is confirmed that the symptoms are not improving. However, if the symptoms improve due to measures taken by the support unit 32 and the patient is safe, the patient generally does not want to contact a caregiver, etc., and caregivers also generally want to avoid calling an emergency department, police, or medical institution without reason if they can contact the patient directly by phone even if the symptoms do not improve and judge that they can handle the situation themselves. The above-mentioned step-by-step contact and notification process in the panic response process 600 takes into account such circumstances, respect for the dignity and independence of the dementia patient, and consideration is given to reducing the psychological burden on caregivers, etc.

(Follow Process)
In the follow-up process 400, the contents of the communication to the other party, the caregiver, etc. differ depending on whether the going-out schedule S2 as the plan B is selected or the returning-home schedule SH is selected.

Figure 11 shows an example of a flowchart of the follow process 400 when the outing schedule S2 is selected. The navigation unit 31 checks whether or not there is a specific person preset in the initial outing schedule S1 at the next destination (401), and if not, ends the follow process 400. If there is a specific person, it checks whether or not it is necessary to contact the other person (402), and if it is not necessary, it also ends the process. If it is necessary to contact, it checks the subject to be contacted (403), and if the subject is the patient himself/herself, the navigation unit 31 outputs a predetermined guide voice (for example, "Please tell Mr./Ms. X that you will be X minutes late." from the countermeasure database C (404), calls the other person with the patient's consent, and after confirming the completion of the contact, ends. If the subject is a caregiver, etc., the navigation unit 31 automatically calls the caregiver terminal 2 and informs the patient of the delay and the new expected arrival time (405). After the caregiver, etc. makes a phone call to the other person himself/herself, it responds to the server 3 from the caregiver terminal 2 that it is complete (406). If there is no response from the caregiver, the navigation unit 31 calls the other party instead, notifying them of the patient's delay and the new expected arrival time (407), and ends the process. If the subject is the patient himself/herself and the contact with the other party is not completed within the preset allowable time, the patient is notified by a guide voice, and the process moves to the case where the subject of the contact with the other party is a caregiver, etc. (405).

Figure 12 shows an example of a flowchart when the home schedule SH is selected. The process procedure is the same as in Figure 11, but the content of the communication to the other party and caregiver, etc. is to cancel the plan.

The dementia patient outing support system of the present invention ensures the safety of the patient and the peace of mind of caregivers, even when the patient goes out alone to a destination and route that is new to the patient, by coordinating the above-mentioned multiple processes. However, the severity of dementia patients' symptoms varies greatly from person to person, and it is difficult to generalize how each patient will respond to guidance and support. Therefore, prior to the "real" patient going out alone, the patient is given a "virtual experience" or "dry run" of going out according to the outing schedule, thereby verifying the validity of the created outing schedule in advance, and the accuracy and safety of the navigation and support can be improved by appropriately changing the navigation method, guide voice, and support voice as necessary.

In this embodiment, the system is configured to be operable in three modes: (1) simulation mode, (2) orientation mode, and (3) going-out support mode. (3) Going-out support mode is a mode that supports the patient going out alone. Figure 13 illustrates an overview of these three modes, Figure 14 illustrates the process executed in each mode, and Figure 15 illustrates the operation of the system in these three modes.

(1) In the simulation mode, the caregiver, etc., rather than the patient himself/herself, wears the patient terminal 1 and performs going-out actions in accordance with the going-out schedule S1 in place of the patient. In this mode, the vital sensors and motion sensors are basically not used, and while executing the guide process, the video and audio data from the video input means 12 and the audio input means 14 are recorded and saved as log data L. After the caregiver, etc., finishes the going-out action and returns home, the management application 20 of the caregiver terminal 2 plays the video and audio of the log data L from the server 3 on an AV monitor such as a large screen television, and the patient watches them. This allows the patient to virtually experience going-out actions according to the going-out schedule S1. At that time, the caregiver, etc., pauses the playback of the log data L as appropriate while watching the patient's reaction and listens to the patient's opinions and impressions. If there are any problems or deficiencies in the going-out schedule S1, the contents of the navigation, or the guide audio, they can use the management application 20 to correct, change, add, or delete them each time, thereby improving the accuracy and effectiveness of the present system.

(2) In the orientation mode, the patient wears the patient terminal 1 and goes out according to the going out schedule S1 accompanied by a caregiver. In this mode, all sensors are used, and the caregiver does not interfere with the patient as much as possible unless there is a major problem or danger, monitors the patient's vital data displayed on the caregiver terminal 2, and observes the effectiveness of the navigation and the patient's reaction. If the patient's behavior is actually delayed or deviated from the going out schedule S1, the caregiver does not intervene and verifies the effectiveness of the follow-up process 400, except when the patient does not select either the proposed going out schedule S2 or the home schedule SH despite the delay/deviation response process 300 being executed. Alternatively, if the accompanying caregiver determines that the patient is not in imminent danger, the patient may wait for a predetermined time to pass without making the selection and finally wait for the panic response process 600 to be executed, and then verify its effectiveness.

In addition, if symptoms of dementia develop, the accompanying caregiver or the like will identify the event that triggered it and verify the effectiveness of the support process 500 and panic response process 600. After the caregiver or the like finishes the outing and returns home, the caregiver or the like (1) reviews the log data L by playing it back on the management application 20 or an external AV monitor, just as in the simulation mode, and can correct, change, add, or delete problems or deficiencies in the outing schedule S1, the content of the navigation and support, or the guide and support voices, based on the verification results from the accompanying visit, thereby making it possible to further improve the accuracy and effectiveness of the present system.

For one outing schedule S1, by executing (1) simulation mode and/or (2) orientation mode and reviewing the log data L, it is possible to significantly improve the safety of the patient and the sense of security of the caregiver when going out alone in the "real" (3) outing support mode. Furthermore, by similarly reviewing the log data L for going out alone in (3) outing support mode, it is possible to address problems that may arise due to differences in the external environment, such as the time of day and weather. Furthermore, it is natural that dementia patients may forget or have vague memories of experiences they have had going out, but even in such cases, the patient can recall or solidify the experience by viewing and "reviewing" past log data L, thereby deepening the patient's own sense of security and self-confidence.

As described above, the accuracy and safety of the system itself can be improved by reviewing and verifying the system in three modes using log data L, updating the schedule and system, and repeatedly taking the patient out for real. Furthermore, with the support of this system, the patient will be able to go out on their own to more destinations and on more occasions, and above all, will have the successful experience of being able to "go about on their own," which will encourage them to go out more proactively, which is expected to have an effect on slowing the progression of dementia.

The specific configuration of the dementia patient outing support system according to the present invention has been described above, but the present invention is not limited to the above embodiment, and improvements or modifications are possible within the scope of the technical idea of the present invention, and these belong to the technical scope of the present invention.

The dementia patient outing support system of the present invention can be used as a personal system to support dementia patients in going out on their own, but by accumulating and analyzing the outing behavior of many dementia patients as log data, it can become research material for factors that hinder the behavior of dementia patients in road environments, public transportation, public facilities, etc., and events that trigger the onset of symptoms. This is expected to contribute to research into the mechanisms of dementia and countermeasures, as well as to the improvement of social infrastructure for dementia.

Criteria for assessing the degree of independence in daily life for elderly people with dementia (excerpt) Example of a parameter table (precursor stage) Example of a parameter table (onset stage) Example of a countermeasures table Support voice example Overall configuration of this system Out of Office Scheduling Process Flowchart Flowchart of guide process and delay deviation response process Navigation example Support process and panic response process flowchart Flowchart of the follow process (when out-of-office schedule is selected) Flowchart of the follow-up process (when a home-home schedule is selected) Overview of the three modes Processes executed in each mode Three modes of operation of this system

C Countermeasures database E Emergency and police terminals L Log data M Medical institution terminals N Internet R Reference condition data S Outing schedule W Various web services
REFERENCE SIGNS LIST 1 Patient terminal 10 Position detection means 11 Status detection means 12 Video input means 13 Voice recognition means 14 Voice input/output means 15 Control communication unit (patient terminal)
2 Caregiver terminal 20 Management application 21 Control communication unit (caregiver terminal)
3 Server 30 Memory unit 31 Navigation unit 32 Support unit 33 Control communication unit (server)

Claims (4)

A dementia patient outing support system comprising a patient terminal attached to the patient's body, a caregiver terminal having a management application, and a server capable of communicating with the patient terminal and the caregiver terminal via the Internet and a mobile communication network,
The patient terminal includes at least a position detection means, a condition detection means capable of detecting condition data of a patient, a voice input/output means, a video input means, and a voice recognition means;
The server includes at least a storage unit, a navigation unit, and a support unit;
The storage unit is
an outing schedule generated by the navigation unit based on the setting input of the patient's outing trip, the outing schedule including at least a round trip route to a destination, times and transfers of public transportation to be used, a stay time at the destination, and a planned return time;
Reference state data is normal state data including a standard walking speed of an individual patient;
A parameter table defining criteria for determining symptoms of dementia;
A countermeasure table that defines the relationship between countermeasures to be taken according to symptoms, a guide voice for navigation, a support voice for support corresponding to each countermeasure in the countermeasure table, and a countermeasure database that registers voice data such as a contact voice for a predetermined target other than the patient, can be set, rewritten, added, deleted, and stored by the management application;
Throughout the patient's journey,
The navigation unit executes navigation by voice guidance corresponding to an outing schedule,
when a delay or deviation is detected due to a mismatch between the patient's current location detected by the location detection means and the planned location in the going - out schedule, a route to the destination at the time of detection is recalculated, and when it is determined based on the result of the recalculation that returning to the going -out schedule is impossible, a next-best modified schedule from the current location to the destination and home and a home schedule from the current location to the home after abandoning the going-out behavior are recalculated based on the time and location at the time of determination, and presented to the patient, and navigation is performed according to the patient's selection.
The support unit compares the patient's condition data detected by the condition detection means with the reference condition data, and if a symptom of dementia defined in the parameter table is detected as a result of the comparison, the support unit refers to the countermeasures table and executes a countermeasure to output a predetermined support voice corresponding to the symptom. The dementia patient outing support system according to claim 1, characterized in that, when the support unit detects symptoms of dementia, the navigation unit recalculates the changed schedule and the return home schedule after reducing the standard walking speed by a predetermined rate, presents them to the patient, and performs navigation according to the patient's selection. The server, throughout the patient's outing,
A dementia patient outing support system as described in either 1 or 2, characterized in that the patient's condition data detected by the condition detection means and the audio/video data input from the audio input/output means and the video input means are integrated and transmitted to the caregiver terminal, and can be monitored by the management application. The server, throughout the patient's outing,
generating log data by integrating in time series a record of the navigation performed by the navigation unit, a record of the patient's condition data, a record of the measures performed by the support unit, and each of the audio and video data recorded by the audio input/output means and the video input means, and storing the log data in the storage unit; and enabling the management application to output the log data on the caregiver terminal;
The dementia patient outing support system according to claim 3, characterized in that the navigation guide voice corresponding to the schedule or the support voice corresponding to measures can be reconfigured from the management application as necessary.

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